Iowa board bans telemedicine abortions

Aug. 30, 2013
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Greg Hoversten / The Des Moines Register

by Tony Leys, The Des Moines Register

by Tony Leys, The Des Moines Register

DES MOINES, Iowa -- A state-panel voted Friday to ban a video-conferencing system that Iowa doctors have used to provide abortion pills to more than 3,000 women across the state since 2008.

Debate over the Planned Parenthood system has been steeped in the divisive politics of abortion. But the Iowa Board of Medicine insisted Friday that their decision was based solely on patient safety concerns.

"How can any of us possibly find that a medical abortion performed over the Internet is as safe as one provided by a physician in person?" board Chairman Greg Hoversten asked his colleagues.

The Iowa City physician said complications from the pills can be serious.

"The woman essentially goes home and labors and delivers a fetus," he said. "It's very bloody. It's painful. There's cramping, pelvic cramping."

That's why the physician should be close at hand to help women deal with complications, he said.

Hoversten has publicly stated his opposition to abortion in general. He and the other nine board members were appointed by Gov. Terry Branstad, who also opposes abortion. But the governor and the board members denied that their actions were aimed at curtailing abortions.

Planned Parenthood of the Heartland President Jill June wasn't buying it.

"Proponents of this rule aren't against telemedicine technology; they are against safe, legal abortion and are unjustly targeting our system with no scientific information or evidence to back their claims," she said in a prepared statement after the vote.

In an interview, June declined to say whether her group would appeal the matter in court. "But we certainly are not going to roll over and let the rights of rural women get trampled like this," she said.

Sue Thayer of Storm Lake, a former Planned Parenthood clinic manager who is now an anti-abortion activist, hailed the 8-2 decision. Thayer and other critics contend that the telemedicine system relies on unqualified staff in outlying clinics who perform sonograms and other medical tests.

"Common sense prevailed," Thayer said after the board's ruling.

She said abortion opponents expect Planned Parent to sue, but she said she's confident her side will succeed in the long run.

"I'm a Christian, and I know who's on our side," she said.

The system, the first of its kind in the nation, is touted as a way to provide abortion services in towns where no other doctors offer them. Planned Parenthood doctors in Des Moines talk via closed-circuit video with patients in more than a dozen outlying clinics. The doctors also view test results, then enter a computer command that opens a drawer in front of the patient. The patient withdraws pill bottles, and takes the first pill as the doctor watches. Then she goes home, takes more pills and has what amounts to an induced miscarriage. The service is offered to women who are in their first nine weeks of pregnancy.

Planned Parenthood supporters note that no patients have complained to state regulators about their experience with the system.

Several board members said it's vital that patients taking abortion pills have a relationship with their doctor, so they know whom to call with questions and concerns.

"This is a big deal. This isn't like taking an aspirin," said Frank Bognanno, a Catholic priest from Des Moines who serves as one of three non-physician members of the board.

The new rules would require doctors to meet with patients in person before providing abortion pills, and to schedule in-person follow-up visits. Barring a court fight, the rules could take effect as soon as November.

Board member Ann Gales, an Algona lawyer, was one of two no votes. She told her colleagues that she understood some of the safety concerns some people have about the Planned Parenthood system, but she said the board appeared to be rushing to pass the new rules without sufficient consideration.

"I absolutely would vote for the right rules that addressed legitimate safety concerns," but the ones under consideration weren't properly written, she said.

For example, Gales said, the rules wouldn't solve the problem of rural women lacking follow-up care. If the telemedicine system is shut down and rural women have to travel to urban clinics for abortion pills, she said, they still would go home to complete the abortion. If complications arose there, they could have trouble finding immediate assistance, she said.

Friday's vote reversed a decision made by previous board members, who determined in 2011 that the Planned Parenthood system was acceptable.